When the International AIDS Society announced that the 19th International AIDS Conference would be held in Washington, DC, some advocates saw an instant opportunity: tens of thousands of scientists, activists, government officials, and journalists descending on Washington four months before a presidential election, all pressing President Obama and the U.S. administration to keep their promise on AIDS. The shift that made it possible to host the AIDS conference in the US for the first time in 22 years—U.S. repeal of an archaic law denying admission to people living with HIV—lent a spirit of optimism to the event, particularly after Secretary of State Hillary Rodham Clinton announced an “AIDS-Free Generation” as a U.S. policy priority.

Others felt their hearts sink when Washington was chosen for the conference. These were the millions of people who, by virtue of having a history of drug use or prostitution, remain inadmissible to the U.S. under current law. In order to apply for a U.S. nonimmigrant visa or a visa waiver, all persons must answer the following two questions, even if the sole purpose of their visit is to attend a conference:

Are you or have you ever been a drug abuser or drug addict?

Are you coming to the United States to engage in prostitution or unlawful commercialized vice or have you been engaged in prostitution or procuring prostitutes within the past 10 years?

Answering “yes” to either of these questions renders an applicant ineligible for a U.S. visa, though the consulate may grant a waiver and let people in at its discretion.

Drug users and sex workers represent the majority of people living with HIV in many countries, and are among the most at-risk of infection everywhere. The irony of allowing people living with HIV to the conference while refusing those likeliest to be—or become—infected has not been lost on everyone. Towards the end of the 2010 International AIDS Conference in Vienna, Indian activist Meena Seshu called for a boycott of AIDS 2012, making the self-evident point that it was unethical 31 years into the AIDS epidemic to discuss matters of AIDS policy in the absence of those most affected. But the response was muted.

Drug users and sex workers working to end AIDS find themselves in an untenable position. Aside from the usual barriers to conference attendance—expensive flights, prohibitive registration fees, limited scholarships—they now have to choose between lying on their visa application form (which is of course against the law) or risk getting rejected for a visa (and potentially having this recorded for any future attempt to visit the U.S. or countries with whom the U.S. may share immigration information). Many have understandably chosen to boycott the conference: starting in Kiev on July 9, drug users and people living with HIV from Eastern Europe will host their own conference to discuss issues of HIV policy that matter to them. Sex workers and their allies will follow with a side meeting in Kolkata the week of AIDS 2012. The International AIDS Society considers Kiev and Kolkata to be “hubs” of the main event, but they are as much a protest against the main meeting as a satellite of it.

The Obama Administration could have prevented this. They could have issued a blanket waiver of inadmissibility for meeting delegates, as they did for people living with HIV when that ban remained in effect during the 2008 UN High-Level Meeting on HIV/AIDS in New York. They could have issued a public statement promising to streamline individual waiver requests, including setting timelines and allowing automatic review of negative recommendations. They could have reassured participants that they would look favorably upon applicants seeking a waiver for the sole purpose of attending a conference. All they did, according to a letter issued on March 30 but not released by the International AIDS Society until June 21, was place the conference on a list of events provided to U.S. missions and notify those missions of the importance of the conference.

The conference, which has ironically chosen the theme “Turning the Tide Together,” will begin on July 22. In the days leading up to it, drug users, sex workers and their allies from around the world will not be silent. In Kiev, Kolkata, and via Twitter, Facebook, and the website www.hivhumanrightsnow.org, they will share their messages with conference delegates about what is needed to end AIDS. Hopefully the conference delegates in Washington—who have been denied their right to hear from these communities in person—will listen closely.